Impact Autism Sc
NPI #1548083769 in Brooklyn Center, Minnesota
Provider Information
- NPI Number
- 1548083769
- Entity Type
- Organization
- Organization Name
- Impact Autism Sc
- Primary Specialty
- Early Intervention Provider Agency
- Enumeration Date
- Nov 5, 2024
- Last Updated
- Nov 5, 2024
Practice Location
- Address
- 6160 SUMMIT DR N STE 200
- City
- Brooklyn Center
- State
- Minnesota
- ZIP Code
- 55430-2181
- Phone
- (619) 576-6887
Authorized Official
- Name
- FADUMO ADEM
- Title
- OPERATIONAL MANGER
- Phone
- (619) 576-6887
Specialties & Taxonomy Codes
| Specialty |
|---|
| Early Intervention Provider Agency |
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